Preventive health care knowledge about respiratory diseases

The core logic of respiratory disease prevention is actually very straightforward - control the entrance of pathogens, maintain the barrier of the respiratory tract, and monitor abnormal signals. If you do these three points, you can block more than 90% of common respiratory infections. There is no need to wait for a cough, fever, or a stuffy nose that makes you unable to sleep before rushing to the hospital.

To be honest, I have been in the respiratory department for almost 8 years, and I have seen too many prevention pitfalls that people step on, and many people have problems because of "over-protection". Last week, I met a young girl who works in Internet operations at the outpatient clinic. She bought an N95 mask and wore it every day to prevent the flu. She didn’t take it off when commuting on the subway or sitting in the office. She wore it for a week. Every time she took it off, the inner layer was so wet that water could be squeezed out. She finally coughed for almost two weeks and was diagnosed with viral bronchitis. Regarding the selection of masks, there is actually no absolutely unified standard in the academic community: those who advocate high protection believe that N95 should be worn whenever going to public places, which can block droplets and aerosols to the greatest extent ； The other group believes that surgical and even ordinary medical masks are sufficient in ordinary scenarios. The moisture from wearing a high-protection mask for a long time will destroy the moisture of the respiratory mucosa, giving the virus an opportunity to take advantage of it. I wear N95 every day at work and in the outpatient clinic, and I change into ordinary medical masks when I go to the supermarket or go to the park after work. It is not necessary to wear the highest level of protection in all scenarios, just adapt to the environment.

Rather than worrying about which mask to wear, what is actually more important is the barrier function of our respiratory tract itself. Many people always want to rely on external things to "supplement" it, but ignore the body's own protective power. Two years ago, when the seasons changed, I always felt my throat was dry. I sprayed my throat with sea salt water in the morning and evening. After spraying for more than half a month, I always felt that my respiratory tract was tight. After asking the old director of our department who was about to retire, I found out that ordinary people who don’t have rhinitis or allergies don’t need to spray the respiratory tract every day. The mucous membranes have a stable flora environment. Excessive flushing will upset the balance. The tips he gave are particularly useful: when the heating is on in autumn and winter, put a wrung-out wet towel on the bedside before going to bed. It is more effective than the humidifier that many people buy that is hundreds of dollars larger. It will not spray mold into the air because the humidifier was not cleaned. Last month, an old man just had a baby. The humidifier was not washed for three months and turned on every day. In the end, he got fungal pneumonia and had to stay in the hospital for almost ten days.

Of course, that doesn’t mean you don’t need to take any protective measures. Paying more attention to the signals your body sends out can save you a lot of trouble. Many people quickly take antibiotics as soon as they have a sore throat. This is also a controversial habit: some people think that taking medicine as soon as symptoms appear can "nip the cold in the cradle." Some studies have shown that blindly taking antibiotics will destroy the normal flora of the respiratory tract, making it easier for repeated infections. My own habit is that if you only have a dry throat, a slight cough, no fever, or body aches, you should drink more warm water and rest for 12 to 24 hours. Most common viral infections can be overcome by yourself. ； But if you are an elderly person with underlying diseases such as COPD and asthma, as long as your asthma worsens and your expectoration becomes more and more yellow, don’t wait, go directly to the hospital, and don’t hold it until it becomes severe.

As for the various preventive remedies that are so popular online, I have been asked about them 800 times by patients. For example, can vitamin C prevent respiratory infections? The American Nutrition Society believes that large doses of vitamin C cannot prevent colds, but at best can slightly shorten the course of the disease. ； Domestic clinical studies have also shown that supplementing about 100mg of vitamin C every day during the change of seasons can indeed reduce the risk of infection in susceptible people. I personally feel that eating two more oranges and kiwis is more reliable than taking any synthetic supplements. Some people say that morning jogging in winter can build up immunity. A colleague of mine went out to run five kilometers at 6 a.m. every day to prevent colds. As a result, he had a fever after running for half a month and was hospitalized. The cold air directly stimulated the respiratory tract. In addition, he had allergic rhinitis, which actually induced asthma. In fact, you don’t have to choose the coldest time to exercise. Go out for half an hour and play badminton at three or four in the afternoon when the sun is bright. The effect is no worse than running in the morning.

In fact, in the final analysis, the respiratory tract is the body system that has the most contact with the outside world. It is not so delicate and cannot withstand messing around. There is no need to strictly follow various "perfect prevention lists" and blame yourself. Dress more when the weather is cold. Remember to wear a mask in crowded places. Don't stay up late all the time to deplete your immunity. It is more effective than any expensive health care products. Oh, by the way, if you really have a cough that has not improved for more than a week, or you are breathing heavily and there is blood in your sputum, don’t just go to the hospital and take a X-ray to check. It is always safe.